NPIMap

Organization Active NPI

Keller Smiles LLC

  • Dental Clinic/Center
  • Keller, TX
National Provider Identifier
1104478635
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KELLER SMILES LLC
Practice address
1540 Keller Pkwy Ste 140
Keller, TX 76248-3685
Phone
(682) 593-0993
Fax
(682) 593-0995
NPI assigned
Jul 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jesus Alvarado
Title
Office Manager
Phone
(682) 593-0993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1540 Keller Pkwy Ste 140
Keller, TX 76248-3685

Mailing address

PO Box 4400
Salem, OR 97302-8400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1104478635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4400",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973028400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 KELLER PKWY STE 140",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483685",
            "telephone_number": "682-593-0993",
            "fax_number": "682-593-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "ALVARADO",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "682-593-0993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.